2008 U.S. Index of Health Ownership

2008 U.S. Index of Health Ownership

August 14, 2008John R. Graham
San Francisco-Americans lack the basic freedom to make their own health care decisions according to the second edition of the U.S. Index of Health Ownership, an annual report by the Pacific Research Institute (PRI). The Index measures the degree to which individuals, be they patients, health professionals, entrepreneurs, or taxpayers, "own" the health care in their states.

National Think Tank Releases State Rankings on Health Ownership

Alabama Comes Out on Top, New York Finishes Last

San Francisco-Americans lack the basic freedom to make their own health care decisions according to the second edition of the U.S. Index of Health Ownership, an annual report by the Pacific Research Institute (PRI). The Index measures the degree to which individuals, be they patients, health professionals, entrepreneurs, or taxpayers, “own” the health care in their states.

“The lack of health ownership is a real problem,” said John R. Graham, director of Health Care Studies at PRI and author of the Index. “Almost half of the country’s health care spending is in the hands of the government, instead of patients themselves. The other half is governed by regulations inflicted upon doctors, health plans and patients.”

State Ranking Results

The Index uses 24 variables to quantify how state laws and regulations affect the liberty of citizens involved in state government health plans (primarily Medicaid), the private health-insurance market, and the provision of medical services. It also assesses the effect of medical tort on people’s freedom to engage health services.

Alabama, Montana, Nebraska, North Dakota, and New Hampshire finished in the top five, as the states that allow their citizens the highest degree of health ownership. Alabama leads the pack primarily because of a lightly regulated private insurance market, and good control of state government programs. Also, the state performs well on medical tort indicators. Alabama’s regulatory environment for providers favors competition, and government health programs run more effectively than in most states.

Michael Ciamarra, vice president of the Alabama Policy Institute, said “We’re very pleased with Alabama’s ranking, but it also illustrates that access to health care doesn’t necessarily translate into positive health outcomes – Alabamans rank poorly in important health categories such as obesity and diabetes. This reinforces even more the importance of health freedom and the ability of patients to take control of their own health care.”

Alabama State Senator Scott Beason, said “As a small businessman, I know that government interference in the ability of Americans to take control of their own health care drives up costs, reduces choice, and limits the overall access to care. I am proud to see that Alabama is ranked at the top in the U.S. Index of Health Ownership. I hope that this will help motivate more Alabamans to live healthier lifestyles. I do note from the Index that our state still over-regulates many of the healthcare providers and the services they provide. Alabama can offer it citizens the finest health care in the world, but we can only do that by providing more choices and freedom in the market. The state legislature needs to put deregulation of the supply of health care near the top of its agenda. Our citizens deserve it.”

New York, Massachusetts, Rhode Island, Vermont, and North Carolina rounded out the bottom five, as the states in which the government has taken the most undue control of health care from its citizens. This is the second year that New York was in last place. The state suffers from government health-care programs that are out of control, a grossly overregulated private-insurance market, and almost completely uncompetitive provider markets.

A full listing of all 50 states and their rankings is contained in the Index.

“The Index will give concerned citizens a good basis to demand reforms from their state politicians that will put American families in charge of American health care, instead of government and special interests,” said Mr. Graham.